labor with IST?

I am a 27 year old female with Inappropriate Sinus Tachycardia.  In January of 02, I had my first catheter ablation.  It seemed to work for a few months,a nd then about 5 months later, I got a "migraine" that would not go away. After being in and out of the hospital for a couple of weeks, they found that my heart rate was not rising over 40, and was in a junctional rhythm.  They decided to implant a pacemaker to regulate my heart rate, and for a couple of years I was ok...minor lightheadedness, palpitations, but nothing I couldnt' handle.  Then, a little over a year ago, my symptoms got bad again, and my cardiologist chose to do a second ablation.  It took over 10 hours as they couldnt' get my heart rate to not react inappropriately to stimulus.  A year later, already symptoms are beginning to come back.  I haven't had any luck with meds as they cause my blood pressure to drop, and it is normally lower than 95/70.

But...all of this is really just background information. My main question is about labor and delivery with my condition. My husband and I are trying to get pregnant, and I was wondering whether labor itself will be safe.  Should I schedule a c-section?  I would like to have a natural birth, but I am very concerned about how my heart will react.

[Michael J. McWilliams, M.D.]

Inappropriate sinus tachycardia does not usually cause problems during child birth.  Obvsiously, the final decison is between your and your doctor.  I would advise one of my own patients to proceed with a vaginal delivery and if the OB thinks there are potential problems, they can convert the procedure to a C section. It is likely that your doctor will recommend the same unless their are special circumstances.